Saturday, May 11, 2024

Quicksilver 100K 2024: challenging therapy...

I know, I keep saying and reminding myself, this isn't cancer. But I'm still very much struggling. Nobody is of course, I was certainly not meant to be an injured runner either. So much that thinking about running hurts. I'm trying to stay away from Facebook where I am connected to more than a thousand running buddies. I've passed on Ken's plea to help at Miwok because I didn't want to spend a day deep in the running spirit. These past years I've made a practice of recognizing injured runners which leveraged their recovery time to give back even more to our running community. I found that admirable. Not that this come as a surprise: since I got into ultra running in 2006, I've been surrounded and served by many ex runners. If it wasn't for them, we wouldn't have so many races.

This weekend marked the 5th and last DNS of the year. I missed Jed Smith 50K because if a minor calf injury and I wanted to be extra cautious not to come back to fast. Then I badly blew up my knee on my birthday, a week before the 50K Road Nationals in March. Having turned 60, I was excited to kill it and compete for a 16th Age Group win of our local Mountain, Ultra, Trail Grand Prix. My first race in this new age group was Knickerbocker 35K in Auburn. 3rd no show. Then Horseshoe Half Marathon in April, for DNS #4. This time, there is some progress, I made it to the check-in at Sports Basement

To tell you how much I am struggling, I've dream running 100 grueling kilometers to the last minute. I was so tormented that I had the typical bad sleep we often experience before big races. And I showed up at the Hacienda parking lot at 3:15 am. Out of 10 editions, this would have been my 9th Quicksilver 100K, I'm getting used to the insane early start, almost a routine.

So tormented that I had to talk to my Sports Medicine doctor in France on Friday to check if it was ok to run long with such pain. I know, it's foolish to even have such thoughts, although I know of quite a few other ultra runners pushing it through pain that bad. Being at the start, seeing and feeling the vibe was tough. At least I was able to do it, and help my running club and this community which I'm so passionate about.

I worked on the parking monitoring duty, at the main gate. This year, Bob was quite happy with the overall result, it went quite smooth thanks to a lot of preparation of the field this past week, as he assembled a team of volunteer to cut the grass before the County actually showed up to do it. That gave ample spots for all the 100K runners, well deserved location near the finish line after such an effort, while the 50K runners had to park on a remote lot like last year. Grateful to everybody for complying with our directions! Under Bob's direction, our overall Chief Volunteer Officer, great teaming with Jim Yates, Jeff Eisenman, Jeff Pace and John Shi.

I got a glimpse of the start at 4:30 am, under a wonderful star show:

On the 100K, we had runners arriving until 5 minutes before the start! One actually got in 20 minutes late, only to come back to the start one hour later, after missed a turn and the course monitor who had moved to another location. Stuart, co-RD, drove him back to the turn he missed, first class service!

The sun, with its heat, starting hitting the Hacienda entrance area right for the 50K start.

One particular incident on that race too: one of the leaders had forgotten his bib and had to run back down the hill and start over...

I helped at the start/finish area for another 30 minutes then drove up to the Hicks aid station. As I arrived, Chief Entertainment Office and Chief Fun Officer, Greg Lanctot, was working his magic, at an aid station which isn't lacking any under Clare's leadership already!

That was after the early morning and dawn rush of getting the first passage of the 100K runners through, and minutes before the 50K runners made their turnaround at mile 6. Note the European touch with the flags (and Clare's UTMB finisher jacket). Much appreciated by Christine.

I stayed until the return of the first 100K runner, the most anticipated Steven Kool, returning 2023 champion.

After 9 editions, I still own the 9th fastest time, these things don't last for ever... 

For a big change, no finisher model or award on this race goodies picture. What a bag this year but, please, if you are a runner, do NOT use it as drop bag next year, please...! The ice bandana had a lot of success for what was going to be the first heat training session of the season for most, well done!

As for the small race logo on the back of the t-shirt, that is certainly original, I had never seen such design.

With that, at least this is a same-day race report, short of having run it and even knowing the results. I still don't know when, or even if I'll get back to running. But I know that, if I'm getting back, I'll be even more appreciative... There is that... 14 finishes at this event (8 x 100K between 2015 and 2023, skipping 2020, 2 x 50-mile in 2009 and 2013, 4 x 50K between 2010 and 2014), I can't wait and stop dreaming...

PS: a few more pics while I'm at at it.

A Stevens Creek Strider!
Chris Garcia
Christine Chapon
With Greg
Amanda Williams (wife of legendary Mark Williams, first ever to finish Barkley)

Miranda Siva, sweeping the course with Ellen Taylor

Saturday, April 20, 2024

Knee injury imaging and update

50 days have passed since I awarded myself the worst birthday gift, a major running injury at the end of what was meant to be the ultimate training run before the 50K Road Nationals. So, short of running stories on this blog, here is a medical update after finally getting x-rays and an MRI done this week.

After 6 weeks of running in circles in my mind, figuratively speaking, and obsessing about the likelihood of my ability to run again, I was quite anxious for this peek view inside this critical articulation. Per my previous post, I was fearing that my meniscus was shattered beyond potential repair. Walking still hurts and I can even feel pain in certain positions while sleeping.

Bottom line, it's not straightforward, there is both good and bad news, but it looks like I could still have a few strides left, which I had really doubted about.

The good news first, starting with what my Sports Medicine doctor felt was the most important: there is no trace or arthritis, the cartilage looks healthy, there is that after logging 2.5 rounds around the globe (101,048 km or 62,783 miles). The health of my knees was part of the top questions I was getting from people doubting that so much running was any good for our bodies and, so far, I was telling them that healthy cartilage actually meant to regenerate the more you used it. Part of the theory that, as humans, we were... born to run. I was also adding that, for that mechanism to hold, it did help to have a neutral footing and stride, to preserve joint alignment. Well, jumping diagonally over a puddle might have tested this alignment beyond my limits...

The second good news is that the ligaments are mostly intact. That MRI shot in particular shows that cruciate ligament well straighten through the articulation.

On another image though, my doctor saw some indication that the attach might have suffered. The MRI didn't have enough images to tell for sure though.

Going on with the less good news is that there is synovial effusion but it is limited. At least this explains the loss of full flexion which prevents me from sitting on my heel for instance. This should pass and reduce eventually as the inflammation disappears. I think that effusion corresponds to that white area, as I recall from my appointment.

And now to the more serious issues which, at least, explain the persisting pain. Let's start with the most obvious culprit, not visible on the x-rays but clearly on the MRI: two bone edemas, one at the top of the tibia, one at the bottom of the femur, proving that both bones did touch, yikes! The x-rays show a silverline though, no fracture at least. For my doctor, this could have easily happened given what the compression must have been. Phew!

And, with compression comes the worst news: while the interior meniscus definitely shows some tear/degeneration after 25 years of intensive running, it was still highly functional in its shock absorber role. Yet, that huge pinch between the displaced bones created a fissure, as I could guess from browsing the Internet and alluded to in my previous post. Because of the very limited number of images of the MRI, the presence of a fissure could be confirmed but the size of it not established.

The meniscus is fibrocartilaginous so it can't repair itself. It's not vascularized and there are no nerves so the fissure itself can't be a source of pain. Yet, the mechanical rupture could prevent the knee from functioning properly, hence be painful. But we'll know if that's the case only after the bone edemas heal. Which should take a few more weeks.

Meanwhile, no impact which makes it a challenging for me to do cardio training as I don't particularly enjoy going to the gym and even less so in group class formats.

And that's it for now. Some hope but more patience needed, and even more so as healing slows down with age. That part of aging which sucks... For so many years, I didn't want to believe others saying it, at least you've been warned! ;-)